<%@ Page Title="" Language="C#" MasterPageFile="~/personal-accident/proposalforms/PersonalAccidentProposalMasterPage.master" Async="true"
    AutoEventWireup="true" CodeFile="liberty_proposal_form.aspx.cs" Inherits="personal_accident_liberty_proposal_form" %>

<%@ Register Src="~/controls/usrNoJS.ascx" TagName="usrNoJS" TagPrefix="ucNoJS" %>
<%@ Register Src="~/controls/usrPhoneNo.ascx" TagName="usrPhoneNo" TagPrefix="uc1" %>
<%@ Register Src="~/controls/usrDate.ascx" TagName="usrDate" TagPrefix="uc2" %>
<%@ Register Src="~/controls/usrIdNumber.ascx" TagName="usrIdNumber" TagPrefix="uc3" %>
<%@ Register Src="~/controls/usrNationality.ascx" TagName="usrNationality" TagPrefix="uc4" %>
<%@ Register Src="~/controls/usrSalutation.ascx" TagName="usrSalutation" TagPrefix="uc5" %>
<%@ Register Src="~/controls/usrMaritalStatus.ascx" TagName="usrMaritalStatus" TagPrefix="uc6" %>
<%@ Register Src="~/controls/usrGender.ascx" TagName="usrGender" TagPrefix="uc7" %>
<%@ Register Src="~/controls/usrRelationship.ascx" TagName="usrRelationship" TagPrefix="uc9" %>
<asp:Content ID="Content1" ContentPlaceHolderID="ContentPlaceHolder1" runat="Server">

    <asp:ScriptManager ID="ScriptManager1" runat="server">
    </asp:ScriptManager>
    <div id="container">
        <div id="nav_top">
            <div class="left pad_8yr">
                <a href="/personal-accident/results.aspx" onclick="return confirm('Are you sure to go back?');">
                    <img src="/images/forms_proposal/button/back.png" alt="Back" /></a></div>
            <div class="right pad_8yr">
                <img src="/images/forms_proposal/nav/logo_comparexpress.png" alt="CompareXpress" /></div>
        </div>
        <ucNoJS:usrNoJS ID="usrNoJS1" runat="server" />
        <!-- #Include file="../../includes/body_loader.inc" -->

        <script type="text/javascript">
            IncreaseProgress(5);
        </script>

        <div id="divContent" style="display: none">
            <div id="contentBody">
                <div id="header">
                    <div class="seperator">
                    </div>
                    <div class="right" style="width: 240px">
                        <div class="quotesum_button">
                            <img src="/images/forms_proposal/button/quotesum.png" width="240" height="73" alt="Quote Summary" /></div>
                    </div>
                    <h1>
                        Online Personal Accident Proposal Form -
                        <asp:Label ID="lblProvider" runat="server"></asp:Label></h1>
                    <div class="seperator">
                    </div>
                    <div class="quotesum">
                        <div class="top">
                        </div>
                        <div id="divQuoteSummery" class="body pad_15x">
                            <!-- QUOTE SUMMARY | Start -->
                            <div class="w21per left pad_25xr">
                                <h1>
                                    <asp:Label ID="lblPlanHead" runat="server" Text="Plan Name : "></asp:Label></h1>
                                <p>
                                    <asp:Label ID="lblPlanName" runat="server"></asp:Label></p>
                            </div>
                            <div class="w21per left pad_25xr">
                                <h1>
                                    <asp:Label ID="lblPolicyHead" runat="server" Text="Policy Type : "></asp:Label></h1>
                                <p>
                                    <asp:Label ID="lblPolicyType" runat="server"></asp:Label></p>
                            </div>
                            <div class="w21per left pad_25xr">
                                <h1>
                                    <asp:Label ID="lblPremiumHead" runat="server" Text="Annual Premium  : $"></asp:Label></h1>
                                <p>
                                    <asp:Label ID="lblAnnualPremium" runat="server"></asp:Label>
                                    (+ GST 7%)</p>
                            </div>
                            <!-- QUOTE SUMMARY | End   -->
                        </div>
                        <div class="bottom">
                        </div>
                    </div>
                </div>
                <div class="seperator">
                </div>
                <div id="body">
                </div>
                <div id="divValidationSummary">
                    <asp:ValidationSummary ID="vsproposal" runat="server" CssClass="errorSummary" ValidationGroup="proposal"
                        HeaderText="Oops please complete the form" />
                </div>
                <div style="display: none">
                    <asp:TextBox ID="txtPolicyType" runat="server"></asp:TextBox>
                    <asp:Label ID="lblCompanyId" runat="server"></asp:Label>
                </div>
                <div class="form">
                    <div class="top">
                        <div class="left">
                            <div class="pad_10t pad_35xl white">
                                Online Personal Accident Proposal Form</div>
                        </div>
                        <div class="right">
                        </div>
                    </div>
                    <div class="body">
                        <div class="inner">
                            <div class="pad_20x10y">
                                <div class="hilite">
                                    <div class="top">
                                    </div>
                                    <div class="body_in pad_15x">
                                        <h1>
                                            Proposer's Particulars</h1>
                                        <div class="seperator">
                                        </div>
                                        <div class="w43per left">
                                            <div id="divName">
                                                <div class="w180 left align_right pad_6t pad_7xr">
                                                    <span class="red">*</span> Proposer's / Insured's Name:</div>
                                                <div class="left">
                                                    <asp:TextBox ID="txtName" MaxLength="50" runat="server" size="25"></asp:TextBox>&nbsp;
                                                    <asp:RequiredFieldValidator ID="rfvName" runat="server" CssClass="validationErrorControl"
                                                        ErrorMessage="" ValidationGroup="proposal" ControlToValidate="txtName"></asp:RequiredFieldValidator>
                                                    <asp:RegularExpressionValidator ID="revName" runat="server" ControlToValidate="txtName"
                                                        ValidationExpression="^[a-zA-Z''-'\s]{1,50}$" ValidationGroup="proposal" CssClass="validationErrorControl"
                                                        Text="" ErrorMessage=""></asp:RegularExpressionValidator>
                                                </div>
                                            </div>
                                            <div class="h10">
                                            </div>
                                            <div>
                                                <div class="w180 left align_right pad_6t pad_7xr">
                                                    <span class="red">*</span> Gender:</div>
                                                <div class="left">
                                                    <uc7:usrGender ID="ddlGender" ValidationGroup="proposal" IsEnabled="true" ErrorMessage=""
                                                        runat="server" />
                                                </div>
                                            </div>
                                            <div class="h10">
                                            </div>
                                            <div id="divNRICNo">
                                                <div class="w180 left align_right pad_6t pad_7xr">
                                                    <span class="red">*</span> NRIC Number:</div>
                                                <div class="left">
                                                    <uc3:usrIdNumber ID="ddlIdNumber" runat="server" ValidationGroup="proposal" />
                                                </div>
                                            </div>
                                            <div class="h10">
                                            </div>
                                            <div id="divNationality">
                                                <div class="w180 left align_right pad_6t pad_7xr">
                                                    <span class="red">*</span> Nationality:</div>
                                                <div class="left">
                                                    <uc4:usrNationality ID="ddlNationality" runat="server" ErrorMessage="" ValidationGroup="proposal" />
                                                </div>
                                            </div>
                                            <div class="h10">
                                            </div>
                                            <div id="divAEmail">
                                                <div class="w180 left align_right pad_6t pad_7xr">
                                                    <span class="red">*</span> E-mail:</div>
                                                <div class="left">
                                                    <asp:TextBox ID="txtEmail" MaxLength="50" runat="server" size="25"></asp:TextBox>
                                                    <asp:RequiredFieldValidator ID="rfvEmail" runat="server" CssClass="validationErrorControl"
                                                        ErrorMessage="" ValidationGroup="proposal" ControlToValidate="txtEmail" Display="Dynamic"></asp:RequiredFieldValidator>
                                                    <asp:RegularExpressionValidator ID="revEmail" runat="server" CssClass="validationErrorControl"
                                                        ErrorMessage="" ValidationGroup="proposal" ControlToValidate="txtEmail" ValidationExpression="\w+([-+.']\w+)*@\w+([-.]\w+)*\.\w+([-.]\w+)*"></asp:RegularExpressionValidator>
                                                </div>
                                            </div>
                                        </div>
                                        <div class="w56per left">
                                            <%--<asp:UpdatePanel ID="UpdatePanel1" runat="server">
                                                <ContentTemplate>--%>
                                                    <div id="divPostCode">
                                                        <div class="w180 left align_right pad_6t pad_7xr">
                                                            <span class="red">*</span> Postcode:
                                                        </div>
                                                        <asp:TextBox ID="txtPostCode" size="8" onkeypress="restrictToNumbers(event)" runat="server" MaxLength="6" Width="80px"></asp:TextBox>
                                                       <%-- <asp:ImageButton ID="ibtPostCode" runat="server" CssClass="button" align="absmiddle"
                                                            OnClick="ibtPostCode_Click" Width="108" ValidationGroup="PostCode" AlternateText="Get Address"
                                                            ImageUrl="~/images/forms_proposal/button/getaddress.png" />
                                                        <asp:UpdateProgress runat="server" ID="uplUpProgress" DisplayAfter="500">
                                                            <ProgressTemplate>
                                                                <span style="position: absolute; text-align: right; width: 390px;">
                                                                    <img src="../../images/loading7.gif" id="ldPostCode" alt="loading" />
                                                                </span>
                                                            </ProgressTemplate>
                                                        </asp:UpdateProgress>--%>
                                                        <asp:RequiredFieldValidator ID="rfvPCode" runat="server" CssClass="validationErrorControl"
                                                            Display="Dynamic" ErrorMessage="" ValidationGroup="PostCode" ControlToValidate="txtPostCode"></asp:RequiredFieldValidator>
                                                        <asp:RegularExpressionValidator ID="revPCode" runat="server" CssClass="validationErrorControl"
                                                            Display="Dynamic" ErrorMessage="" ValidationGroup="PostCode" ValidationExpression="[0-9]{6}"
                                                            ControlToValidate="txtPostCode"></asp:RegularExpressionValidator>
                                                        <asp:RequiredFieldValidator ID="rfvPostCode" runat="server" CssClass="validationErrorControl"
                                                            Display="Dynamic" ErrorMessage="" ValidationGroup="proposal" ControlToValidate="txtPostCode"></asp:RequiredFieldValidator>
                                                        <asp:RegularExpressionValidator ID="revPostCode" runat="server" CssClass="validationErrorControl"
                                                            Display="Dynamic" ErrorMessage="" ValidationGroup="proposal" ValidationExpression="[0-9]{6}"
                                                            ControlToValidate="txtPostCode"></asp:RegularExpressionValidator>
                                                    </div>
                                                    <div runat="server" visible="false" id="divAddressList">
                                                        <div class="h10">
                                                        </div>
                                                        <div class="w180 left align_right pad_6t pad_7xr">
                                                            Please choose your address
                                                        </div>
                                                        <asp:DropDownList ID="ddlAddressList" AutoPostBack="true" Width="320px" runat="server" OnSelectedIndexChanged="ddlAddressList_SelectedIndexChanged">
                                                        </asp:DropDownList>
                                                    </div>
                                               <%-- </ContentTemplate>
                                            </asp:UpdatePanel>--%>
                                            <div class="h10">
                                            </div>
                                            <div id="divUnitNo">
                                                <div class="w180 left align_right pad_6t pad_7xr">
                                                    <span class="red">*</span> Unit Number:
                                                </div>
                                                <asp:TextBox ID="txtUnit1" MaxLength="10" runat="server" size="8"></asp:TextBox>-
                                                <asp:RequiredFieldValidator ID="rfvUnit1" runat="server" CssClass="validationErrorControl"
                                                    ErrorMessage="" ValidationGroup="proposal" ControlToValidate="txtUnit1"></asp:RequiredFieldValidator>
                                                <asp:TextBox ID="txtUnit2" MaxLength="10" runat="server" size="8"></asp:TextBox>
                                                <asp:RequiredFieldValidator ID="rfvUnit2" runat="server" CssClass="validationErrorControl"
                                                    ErrorMessage="" ValidationGroup="proposal" ControlToValidate="txtUnit2"></asp:RequiredFieldValidator>
                                            </div>
                                            <div class="h10">
                                            </div>
                                            <asp:UpdatePanel ID="UpdatePanel2" runat="server">
                                                <ContentTemplate>
                                                    <div id="divPCAddress">
                                                        <div class="w180 left align_right pad_6t pad_7xr">
                                                            <span class="red">*</span> Address:
                                                        </div>
                                                        <span id="divAddress"></span>
                                                        <asp:TextBox ID="txtAddress" runat="server" TextMode="MultiLine" MaxLength="120"
                                                            Width="200px"></asp:TextBox>
                                                        <asp:RequiredFieldValidator ID="rfvAddress" runat="server" CssClass="validationErrorControl"
                                                            ErrorMessage="" ValidationGroup="proposal" ControlToValidate="txtAddress"></asp:RequiredFieldValidator>
                                                    </div>
                                                </ContentTemplate>
                                            </asp:UpdatePanel>
                                            <div class="h10">
                                            </div>
                                        </div>
                                        <div class="clear">
                                        </div>
                                        <div class="h10">
                                        </div>
                                        <div style="border: 1px solid #ccc; width: 912px; background: #d2d2d2;">
                                            <div class="h10">
                                            </div>
                                            <div class="w180 left align_right pad_6t pad_7xr">
                                                Contact Info:</div>
                                            <div id="divMobileNo" class="w190 note left">
                                                <span class="red">*</span> Mobile Number<br />
                                                <uc1:usrPhoneNo ID="txtMobileNo" IsEnabled="true" IsRequired="true" PhoneNoRequireErrorMessage="Require mobile number."
                                                    PhoneNoErrorMessage="Mobile phone number should 8 digits." PhoneNoValidErrorMessage="Invalid mobile phone number."
                                                    runat="server" ValidationGroup="proposal" />
                                            </div>
                                            <div id="divOfficePhoneNo" class="w190 note left">
                                                Office Number<br />
                                                <uc1:usrPhoneNo ID="txtOfficePhoneNo" runat="server" ValidationGroup="proposal" IsRequired="False" />
                                            </div>
                                            <div class="h10">
                                            </div>
                                        </div>
                                        <div style="display: none">
                                            <asp:TextBox ID="txtIsCover" runat="server"></asp:TextBox></div>
                                        <div style="display: none">
                                            <asp:TextBox ID="txtCHCount" runat="server"></asp:TextBox></div>
                                    </div>
                                    <div class="bottom">
                                    </div>
                                </div>
                                <div class="seperator">
                                </div>

                                <script type="text/javascript">
                                    IncreaseProgress(20);
                                </script>

                                <asp:Panel ID="pnlSpouse" runat="server" Width="100%">
                                    <div class="hilite" id="divSpouse">
                                        <div class="top">
                                        </div>
                                        <div class="body_in pad_15x">
                                            <h1>
                                                Spouse's Particulars</h1>
                                            <div class="seperator">
                                            </div>
                                            <div class="w43per left">
                                                <div id="divSpouseName">
                                                    <div class="w180 left align_right pad_6t pad_7xr">
                                                        <span class="red">*</span>Name:</div>
                                                    <div class="left">
                                                        <asp:TextBox ID="txtSpouseName" runat="server" MaxLength="50" size="25"></asp:TextBox>
                                                        <asp:RequiredFieldValidator ID="rfvSpouseName" runat="server" CssClass="validationErrorControl"
                                                            ErrorMessage="" ValidationGroup="proposal" ControlToValidate="txtSpouseName"></asp:RequiredFieldValidator>
                                                        <asp:RegularExpressionValidator ID="revSpouseName" runat="server" ControlToValidate="txtSpouseName"
                                                            ValidationExpression="^[a-zA-Z''-'\s]{1,50}$" ValidationGroup="proposal" CssClass="validationErrorControl"
                                                            Text="" ErrorMessage=""></asp:RegularExpressionValidator>
                                                    </div>
                                                </div>
                                                <div class="h10">
                                                </div>
                                                <div id="divSpouseNRICNo">
                                                    <div class="w180 left align_right pad_6t pad_7xr">
                                                        <span class="red">*</span>NRIC Number:</div>
                                                    <div class="left">
                                                        <uc3:usrIdNumber ID="ddlSpouseIdNumber" runat="server" ValidationGroup="proposal" />
                                                    </div>
                                                </div>
                                                <%--<div style="display: none;">
                                                    <asp:TextBox ID="txtNRIC" Text="Valid" runat="server"></asp:TextBox>
                                                    <asp:CustomValidator CssClass="validationErrorControl" ControlToValidate="txtNRIC"
                                                        ValidationGroup="proposal" ID="csvNRIC" 
                                                        OnServerValidate="Check2NRICValid" runat="server" ErrorMessage=""
                                                        Text=""></asp:CustomValidator>
                                                </div>--%>
                                            </div>
                                            <div class="w56per left">
                                                <div id="divSpouseNationality">
                                                    <div class="w180 left align_right pad_6t pad_7xr">
                                                        <span class="red">*</span> Nationality:</div>
                                                    <div class="left">
                                                        <uc4:usrNationality ID="ddlSpouseNationality" runat="server" ErrorMessage="" ValidationGroup="proposal" />
                                                    </div>
                                                </div>
                                            </div>
                                            <div class="clear">
                                            </div>
                                        </div>
                                        <div class="bottom">
                                        </div>
                                    </div>
                                    <div class="seperator">
                                    </div>
                                </asp:Panel>
                                <asp:Panel ID="pnlChildParticulars" runat="server" Width="100%">
                                    <div class="hilite" id="divChilds">
                                        <div class="top">
                                        </div>
                                        <div class="body_in pad_15x">
                                            <h1>
                                                Child's Particulars</h1>
                                            <asp:Panel ID="pnlChild1" runat="server" Width="100%">
                                                <div class="seperator">
                                                </div>
                                                <div>
                                                    <h3>
                                                        Child 1</h3>
                                                    <div class="h10">
                                                    </div>
                                                    <div class="w43per left">
                                                        <div id="divChildName1">
                                                            <div class="w180 left align_right pad_6t pad_7xr">
                                                                <span class="red">*</span> Name:</div>
                                                            <div class="left pad_6t">
                                                                <asp:TextBox ID="txtChildName1" MaxLength="50" runat="server" Width="200px"></asp:TextBox>
                                                                <asp:RequiredFieldValidator ID="rfvChildName1" runat="server" CssClass="validationErrorControl"
                                                                    ErrorMessage="" ValidationGroup="proposal" ControlToValidate="txtChildName1"></asp:RequiredFieldValidator>
                                                                <asp:RegularExpressionValidator ID="revChildName1" runat="server" ControlToValidate="txtChildName1"
                                                                    ValidationExpression="^[a-zA-Z''-'\s]{1,50}$" ValidationGroup="proposal" CssClass="validationErrorControl"
                                                                    Text="" ErrorMessage=""></asp:RegularExpressionValidator>
                                                            </div>
                                                        </div>
                                                        <div class="h10">
                                                        </div>
                                                        <div>
                                                            <div class="w180 left align_right pad_6t pad_7xr">
                                                                <span class="red">*</span> Date of Birth:</div>
                                                            <div class="left">
                                                                <uc2:usrDate ID="ddlChildDOB1" ValidationGroup="proposal" runat="server"></uc2:usrDate>
                                                            </div>
                                                        </div>
                                                        <div class="h10">
                                                        </div>
                                                        <div>
                                                            <div class="w180 left align_right pad_6t pad_7xr">
                                                                <span class="red">*</span> Gender:</div>
                                                            <div class="left">
                                                                <uc7:usrGender ID="ddlChildGender1" ValidationGroup="proposal" IsEnabled="true" ErrorMessage=""
                                                                    runat="server" />
                                                            </div>
                                                        </div>
                                                    </div>
                                                    <div class="w56per left">
                                                        <div>
                                                            <div class="w180 left align_right pad_6t pad_7xr">
                                                                <span class="red">*</span> NRIC Number:</div>
                                                            <div class="left">
                                                                <uc3:usrIdNumber ID="ddlChildIdNumber1" runat="server" ValidationGroup="proposal" />
                                                            </div>
                                                        </div>
                                                        <div class="h10">
                                                        </div>
                                                        <div>
                                                            <div class="w180 left align_right pad_6t pad_7xr">
                                                                <span class="red">*</span> Nationality:</div>
                                                            <div class="left">
                                                                <uc4:usrNationality ID="ddlChildNationality1" runat="server" ErrorMessage="" ValidationGroup="proposal" />
                                                            </div>
                                                        </div>
                                                        <div class="clear">
                                                        </div>
                                                    </div>
                                                </div>
                                            </asp:Panel>
                                            <asp:Panel ID="pnlChild2" runat="server" Width="100%">
                                                <div class="seperator">
                                                </div>
                                                <div>
                                                    <h3>
                                                        Child 2</h3>
                                                    <div class="h10">
                                                    </div>
                                                    <div class="w43per left">
                                                        <div id="divChildName2">
                                                            <div class="w180 left align_right pad_6t pad_7xr">
                                                                <span class="red">*</span> Name:</div>
                                                            <div class="left pad_6t">
                                                                <asp:TextBox ID="txtChildName2" MaxLength="50" runat="server" Width="200px"></asp:TextBox>
                                                                <asp:RequiredFieldValidator ID="rfvChildName2" runat="server" CssClass="validationErrorControl"
                                                                    ErrorMessage="" ValidationGroup="proposal" ControlToValidate="txtChildName2"></asp:RequiredFieldValidator>
                                                                <asp:RegularExpressionValidator ID="revChildName2" runat="server" ControlToValidate="txtChildName2"
                                                                    ValidationExpression="^[a-zA-Z''-'\s]{1,50}$" ValidationGroup="proposal" CssClass="validationErrorControl"
                                                                    Text="" ErrorMessage=""></asp:RegularExpressionValidator>
                                                            </div>
                                                        </div>
                                                        <div class="h10">
                                                        </div>
                                                        <div>
                                                            <div class="w180 left align_right pad_6t pad_7xr">
                                                                <span class="red">*</span> Date of Birth:</div>
                                                            <div class="left">
                                                                <uc2:usrDate ID="ddlChildDOB2" ValidationGroup="proposal" runat="server"></uc2:usrDate>
                                                            </div>
                                                        </div>
                                                        <div class="h10">
                                                        </div>
                                                        <div>
                                                            <div class="w180 left align_right pad_6t pad_7xr">
                                                                <span class="red">*</span> Gender:</div>
                                                            <div class="left">
                                                                <uc7:usrGender ID="ddlChildGender2" ValidationGroup="proposal" IsEnabled="true" ErrorMessage=""
                                                                    runat="server" />
                                                            </div>
                                                        </div>
                                                    </div>
                                                    <div class="w56per left">
                                                        <div>
                                                            <div class="w180 left align_right pad_6t pad_7xr">
                                                                <span class="red">*</span> NRIC Number:</div>
                                                            <div class="left">
                                                                <uc3:usrIdNumber ID="ddlChildIdNumber2" runat="server" ValidationGroup="proposal" />
                                                            </div>
                                                        </div>
                                                        <div class="h10">
                                                        </div>
                                                        <div>
                                                            <div class="w180 left align_right pad_6t pad_7xr">
                                                                <span class="red">*</span> Nationality:</div>
                                                            <div class="left">
                                                                <uc4:usrNationality ID="ddlChildNationality2" runat="server" ErrorMessage="" ValidationGroup="proposal" />
                                                            </div>
                                                        </div>
                                                        <div class="clear">
                                                        </div>
                                                    </div>
                                                </div>
                                            </asp:Panel>
                                            <asp:Panel ID="pnlChild3" runat="server" Width="100%">
                                                <div class="seperator">
                                                </div>
                                                <div>
                                                    <h3>
                                                        Child 3</h3>
                                                    <div class="h10">
                                                    </div>
                                                    <div class="w43per left">
                                                        <div id="divChildName3">
                                                            <div class="w180 left align_right pad_6t pad_7xr">
                                                                <span class="red">*</span> Name:</div>
                                                            <div class="left pad_6t">
                                                                <asp:TextBox ID="txtChildName3" MaxLength="50" runat="server" Width="200px"></asp:TextBox>
                                                                <asp:RequiredFieldValidator ID="rfvChildName3" runat="server" CssClass="validationErrorControl"
                                                                    ErrorMessage="" ValidationGroup="proposal" ControlToValidate="txtChildName3"></asp:RequiredFieldValidator>
                                                                <asp:RegularExpressionValidator ID="revChildName3" runat="server" ControlToValidate="txtChildName3"
                                                                    ValidationExpression="^[a-zA-Z''-'\s]{1,50}$" ValidationGroup="proposal" CssClass="validationErrorControl"
                                                                    Text="" ErrorMessage=""></asp:RegularExpressionValidator>
                                                            </div>
                                                        </div>
                                                        <div class="h10">
                                                        </div>
                                                        <div>
                                                            <div class="w180 left align_right pad_6t pad_7xr">
                                                                <span class="red">*</span> Date of Birth:</div>
                                                            <div class="left">
                                                                <uc2:usrDate ID="ddlChildDOB3" ValidationGroup="proposal" runat="server"></uc2:usrDate>
                                                            </div>
                                                        </div>
                                                        <div class="h10">
                                                        </div>
                                                        <div>
                                                            <div class="w180 left align_right pad_6t pad_7xr">
                                                                <span class="red">*</span> Gender:</div>
                                                            <div class="left">
                                                                <uc7:usrGender ID="ddlChildGender3" ValidationGroup="proposal" IsEnabled="true" ErrorMessage=""
                                                                    runat="server" />
                                                            </div>
                                                        </div>
                                                    </div>
                                                    <div class="w56per left">
                                                        <div>
                                                            <div class="w180 left align_right pad_6t pad_7xr">
                                                                <span class="red">*</span> NRIC Number:</div>
                                                            <div class="left">
                                                                <uc3:usrIdNumber ID="ddlChildIdNumber3" runat="server" ValidationGroup="proposal" />
                                                            </div>
                                                        </div>
                                                        <div class="h10">
                                                        </div>
                                                        <div>
                                                            <div class="w180 left align_right pad_6t pad_7xr">
                                                                <span class="red">*</span> Nationality:</div>
                                                            <div class="left">
                                                                <uc4:usrNationality ID="ddlChildNationality3" runat="server" ErrorMessage="" ValidationGroup="proposal" />
                                                            </div>
                                                        </div>
                                                        <div class="clear">
                                                        </div>
                                                    </div>
                                                </div>
                                            </asp:Panel>
                                            <asp:Panel ID="pnlChild4" runat="server" Width="100%">
                                                <div class="seperator">
                                                </div>
                                                <div>
                                                    <h3>
                                                        Child 4</h3>
                                                    <div class="h10">
                                                    </div>
                                                    <div class="w43per left">
                                                        <div id="divChildName4">
                                                            <div class="w180 left align_right pad_6t pad_7xr">
                                                                <span class="red">*</span> Name:</div>
                                                            <div class="left pad_6t">
                                                                <asp:TextBox ID="txtChildName4" MaxLength="50" runat="server" Width="200px"></asp:TextBox>
                                                                <asp:RequiredFieldValidator ID="rfvChildName4" runat="server" CssClass="validationErrorControl"
                                                                    ErrorMessage="" ValidationGroup="proposal" ControlToValidate="txtChildName4"></asp:RequiredFieldValidator>
                                                                <asp:RegularExpressionValidator ID="revChildName4" runat="server" ControlToValidate="txtChildName4"
                                                                    ValidationExpression="^[a-zA-Z''-'\s]{1,50}$" ValidationGroup="proposal" CssClass="validationErrorControl"
                                                                    Text="" ErrorMessage=""></asp:RegularExpressionValidator>
                                                            </div>
                                                        </div>
                                                        <div class="h10">
                                                        </div>
                                                        <div>
                                                            <div class="w180 left align_right pad_6t pad_7xr">
                                                                <span class="red">*</span> Date of Birth:</div>
                                                            <div class="left">
                                                                <uc2:usrDate ID="ddlChildDOB4" ValidationGroup="proposal" runat="server"></uc2:usrDate>
                                                            </div>
                                                        </div>
                                                        <div class="h10">
                                                        </div>
                                                        <div>
                                                            <div class="w180 left align_right pad_6t pad_7xr">
                                                                <span class="red">*</span> Gender:</div>
                                                            <div class="left">
                                                                <uc7:usrGender ID="ddlChildGender4" ValidationGroup="proposal" IsEnabled="true" ErrorMessage=""
                                                                    runat="server" />
                                                            </div>
                                                        </div>
                                                    </div>
                                                    <div class="w56per left">
                                                        <div>
                                                            <div class="w180 left align_right pad_6t pad_7xr">
                                                                <span class="red">*</span> NRIC Number:</div>
                                                            <div class="left">
                                                                <uc3:usrIdNumber ID="ddlChildIdNumber4" runat="server" ValidationGroup="proposal" />
                                                            </div>
                                                        </div>
                                                        <div class="h10">
                                                        </div>
                                                        <div>
                                                            <div class="w180 left align_right pad_6t pad_7xr">
                                                                <span class="red">*</span> Nationality:</div>
                                                            <div class="left">
                                                                <uc4:usrNationality ID="ddlChildNationality4" runat="server" ErrorMessage="" ValidationGroup="proposal" />
                                                            </div>
                                                        </div>
                                                        <div class="clear">
                                                        </div>
                                                    </div>
                                                </div>
                                            </asp:Panel>
                                            <asp:Panel ID="pnlChild5" runat="server" Width="100%">
                                                <div class="seperator">
                                                </div>
                                                <div>
                                                    <h3>
                                                        Child 5</h3>
                                                    <div class="h10">
                                                    </div>
                                                    <div class="w43per left">
                                                        <div id="divChildName5">
                                                            <div class="w180 left align_right pad_6t pad_7xr">
                                                                <span class="red">*</span> Name:</div>
                                                            <div class="left pad_6t">
                                                                <asp:TextBox ID="txtChildName5" MaxLength="50" runat="server" Width="200px"></asp:TextBox>
                                                                <asp:RequiredFieldValidator ID="rfvChildName5" runat="server" CssClass="validationErrorControl"
                                                                    ErrorMessage="" ValidationGroup="proposal" ControlToValidate="txtChildName5"></asp:RequiredFieldValidator>
                                                                <asp:RegularExpressionValidator ID="revChildName5" runat="server" ControlToValidate="txtChildName5"
                                                                    ValidationExpression="^[a-zA-Z''-'\s]{1,50}$" ValidationGroup="proposal" CssClass="validationErrorControl"
                                                                    Text="" ErrorMessage=""></asp:RegularExpressionValidator>
                                                            </div>
                                                        </div>
                                                        <div class="h10">
                                                        </div>
                                                        <div>
                                                            <div class="w180 left align_right pad_6t pad_7xr">
                                                                <span class="red">*</span> Date of Birth:</div>
                                                            <div class="left">
                                                                <uc2:usrDate ID="ddlChildDOB5" ValidationGroup="proposal" runat="server"></uc2:usrDate>
                                                            </div>
                                                        </div>
                                                        <div class="h10">
                                                        </div>
                                                        <div>
                                                            <div class="w180 left align_right pad_6t pad_7xr">
                                                                <span class="red">*</span> Gender:</div>
                                                            <div class="left">
                                                                <uc7:usrGender ID="ddlChildGender5" ValidationGroup="proposal" IsEnabled="true" ErrorMessage=""
                                                                    runat="server" />
                                                            </div>
                                                        </div>
                                                    </div>
                                                    <div class="w56per left">
                                                        <div>
                                                            <div class="w180 left align_right pad_6t pad_7xr">
                                                                <span class="red">*</span> NRIC Number:</div>
                                                            <div class="left">
                                                                <uc3:usrIdNumber ID="ddlChildIdNumber5" runat="server" ValidationGroup="proposal" />
                                                            </div>
                                                        </div>
                                                        <div class="h10">
                                                        </div>
                                                        <div>
                                                            <div class="w180 left align_right pad_6t pad_7xr">
                                                                <span class="red">*</span> Nationality:</div>
                                                            <div class="left">
                                                                <uc4:usrNationality ID="ddlChildNationality5" runat="server" ErrorMessage="" ValidationGroup="proposal" />
                                                            </div>
                                                        </div>
                                                        <div class="clear">
                                                        </div>
                                                    </div>
                                                </div>
                                            </asp:Panel>
                                        </div>
                                        <div class="bottom">
                                        </div>
                                    </div>
                                    <div class="seperator">
                                    </div>
                                </asp:Panel>

                                <script type="text/javascript">
                                    IncreaseProgress(45);
                                </script>

                                <div class="twoclmn" id="divOtherOnformationHeader">
                                    <div class="top">
                                    </div>
                                    <div class="body pad_15x" id="divOtherInfo">
                                        <h1>
                                            Other Information</h1>
                                        <div class="seperator">
                                        </div>
                                        <div id="divOtherOnformation">
                                            <div id="divOccupationfallstatus" class="mar_10by">
                                                <div class="w650 left align_right pad_10xr">
                                                    <span class="red">*</span> (a) Does your occupation fall within any of the Decline
                                                    of Referred Risks?
                                                </div>
                                                <div class="w220 left pad_20_10x">
                                                    <span id="divYesOccupationfall">
                                                        <asp:RadioButton onclick="ShowHideDiv('divOccupationfall',true);ValOccupationfall(true);CheckOccupationfallValidationCss();"
                                                            ID="rdoYesOccupationfall" runat="server" GroupName="occupationfall" />
                                                        <asp:Label ID="lblYesOccupationfall" class="pad_10xr" runat="server" Text="Yes"></asp:Label>
                                                    </span><span id="divNoOccupationfall">
                                                        <asp:RadioButton onclick="ShowHideDiv('divOccupationfall',false);ValOccupationfall(false);CheckOccupationfallValidationCss();"
                                                            ID="rdoNoOccupationfall" runat="server" GroupName="occupationfall" />
                                                        <asp:Label ID="lblNoOccupationfall" runat="server" Text="No"></asp:Label>
                                                    </span>
                                                    <div style="display: none">
                                                        <asp:TextBox ID="txtOccupationfall" runat="server"></asp:TextBox>
                                                    </div>
                                                    <asp:RequiredFieldValidator ID="rfvOccupationfall" runat="server" CssClass="validationErrorControl"
                                                        Display="Dynamic" ErrorMessage="" ControlToValidate="txtOccupationfall" ValidationGroup="proposal"
                                                        Text=""></asp:RequiredFieldValidator>
                                                </div>
                                            </div>
                                            <div class="h7">
                                            </div>
                                            <div id="divOccupationfall" style="display: ;" class="mar_10by">
                                                <div class="w650 left align_right pad_10xr">
                                                    <span class="red">*</span> Please specify
                                                </div>
                                                <div class="w220 left pad_20_10x">
                                                    <asp:TextBox ID="txtOccupationfallReason" runat="server" Columns="25" MaxLength="100"
                                                        Rows="2" TextMode="MultiLine"></asp:TextBox>
                                                    <asp:RequiredFieldValidator ID="rfvOccupationfallReason" ControlToValidate="txtOccupationfallReason"
                                                        ErrorMessage="" ValidationGroup="proposal" CssClass="validationErrorControl"
                                                        runat="server"></asp:RequiredFieldValidator>
                                                </div>
                                                <div class="h7">
                                                </div>
                                            </div>
                                            <div id="divEngagedSportsstatus" class="mar_10by">
                                                <div class="w650 left align_right pad_10xr">
                                                    <span class="red">*</span> (b) Do you engage in any sports/activities which are
                                                    excluded by the Policy?
                                                </div>
                                                <div class="w220 left pad_20_10x">
                                                    <span id="divYesEngagedSports">
                                                        <asp:RadioButton onclick="ShowHideDiv('divEngagedSports',true);ValEngagedSports(true);CheckEngagedSportsValidationCss();"
                                                            ID="rdoYesEngagedSports" runat="server" GroupName="engagedsports" />
                                                        <asp:Label ID="lblYesEngagedSports" class="pad_10xr" runat="server" Text="Yes"></asp:Label>
                                                    </span><span id="divNoEngagedSports">
                                                        <asp:RadioButton onclick="ShowHideDiv('divEngagedSports',false);ValEngagedSports(false);CheckEngagedSportsValidationCss();"
                                                            ID="rdoNoEngagedSports" runat="server" GroupName="engagedsports" />
                                                        <asp:Label ID="lblNoEngagedSports" runat="server" Text="No"></asp:Label>
                                                    </span>
                                                    <div style="display: none">
                                                        <asp:TextBox ID="txtEngagedSports" runat="server"></asp:TextBox>
                                                    </div>
                                                    <asp:RequiredFieldValidator ID="rfvEngagedSports" runat="server" CssClass="validationErrorControl"
                                                        Display="Dynamic" ErrorMessage="" ControlToValidate="txtEngagedSports" ValidationGroup="proposal"
                                                        Text=""></asp:RequiredFieldValidator>
                                                </div>
                                            </div>
                                            <div class="h7">
                                            </div>
                                            <div id="divEngagedSports" style="display: ;" class="mar_10by">
                                                <div class="w650 left align_right pad_10xr">
                                                    <span class="red">*</span> Please specify
                                                </div>
                                                <div class="w220 left pad_20_10x">
                                                    <asp:TextBox ID="txtEngagedSportsReason" runat="server" Columns="25" MaxLength="100"
                                                        Rows="2" TextMode="MultiLine"></asp:TextBox>
                                                    <asp:RequiredFieldValidator ID="rfvEngagedSportsReason" ControlToValidate="txtEngagedSportsReason"
                                                        ErrorMessage="" ValidationGroup="proposal" CssClass="validationErrorControl"
                                                        runat="server"></asp:RequiredFieldValidator>
                                                </div>
                                                <div class="h7">
                                                </div>
                                            </div>
                                            <div id="divPhysicaldefectstatus" class="mar_10by">
                                                <div class="w650 left align_right pad_10xr">
                                                    <span class="red">*</span> (c) Do you suffer from any disease, physical defect or
                                                    infirmity?
                                                </div>
                                                <div class="w220 left pad_20_10x">
                                                    <span id="divYesPhysicaldefect">
                                                        <asp:RadioButton onclick="ShowHideDiv('divPhysicaldefect',true);ValPhysicaldefect(true);CheckPhysicaldefectValidationCss();"
                                                            ID="rdoYesPhysicaldefect" runat="server" GroupName="physicaldefect" />
                                                        <asp:Label ID="lblYesPhysicaldefect" class="pad_10xr" runat="server" Text="Yes"></asp:Label>
                                                    </span><span id="divNoPhysicaldefect">
                                                        <asp:RadioButton onclick="ShowHideDiv('divPhysicaldefect',false);ValPhysicaldefect(false);CheckPhysicaldefectValidationCss();"
                                                            ID="rdoNoPhysicaldefect" runat="server" GroupName="physicaldefect" />
                                                        <asp:Label ID="lblNoPhysicaldefect" runat="server" Text="No"></asp:Label>
                                                    </span>
                                                    <div style="display: none">
                                                        <asp:TextBox ID="txtPhysicaldefect" runat="server"></asp:TextBox>
                                                    </div>
                                                    <asp:RequiredFieldValidator ID="rfvPhysicaldefect" runat="server" CssClass="validationErrorControl"
                                                        Display="Dynamic" ErrorMessage="" ControlToValidate="txtPhysicaldefect" ValidationGroup="proposal"
                                                        Text=""></asp:RequiredFieldValidator>
                                                </div>
                                            </div>
                                            <div class="h7">
                                            </div>
                                            <div id="divPhysicaldefect" style="display: ;" class="mar_10by">
                                                <div class="w650 left align_right pad_10xr">
                                                    <span class="red">*</span> Please specify
                                                </div>
                                                <div class="w220 left pad_20_10x">
                                                    <asp:TextBox ID="txtPhysicaldefectReason" runat="server" Columns="25" MaxLength="100"
                                                        Rows="2" TextMode="MultiLine"></asp:TextBox>
                                                    <asp:RequiredFieldValidator ID="rfvPhysicaldefectReason" ControlToValidate="txtPhysicaldefectReason"
                                                        ErrorMessage="" ValidationGroup="proposal" CssClass="validationErrorControl"
                                                        runat="server"></asp:RequiredFieldValidator>
                                                </div>
                                                <div class="h7">
                                                </div>
                                            </div>
                                            <div id="divOtherInsurencestatus" class="mar_10by">
                                                <div class="w650 left align_right pad_10xr">
                                                    <span class="red">*</span> (d)Do you have any other personal accident insurance?
                                                </div>
                                                <div class="w220 left pad_20_10x">
                                                    <span id="divYesOtherInsurence">
                                                        <asp:RadioButton onclick="ShowHideDiv('divOtherInsurence',true);ValOtherInsurence(true);CheckOtherInsurenceValidationCss();"
                                                            ID="rdoYesOtherInsurence" runat="server" GroupName="otherinsurance" />
                                                        <asp:Label ID="lblYesOtherInsurence" class="pad_10xr" runat="server" Text="Yes"></asp:Label>
                                                    </span><span id="divNoOtherInsurence">
                                                        <asp:RadioButton onclick="ShowHideDiv('divOtherInsurence',false);ValOtherInsurence(false);CheckOtherInsurenceValidationCss();"
                                                            ID="rdoNoOtherInsurence" runat="server" GroupName="otherinsurance" />
                                                        <asp:Label ID="lblNoOtherInsurence" runat="server" Text="No"></asp:Label>
                                                    </span>
                                                    <div style="display: none">
                                                        <asp:TextBox ID="txtOI" runat="server"></asp:TextBox>
                                                    </div>
                                                    <asp:RequiredFieldValidator ID="rfvOI" runat="server" CssClass="validationErrorControl"
                                                        Display="Dynamic" ErrorMessage="" ControlToValidate="txtOI" ValidationGroup="proposal"
                                                        Text=""></asp:RequiredFieldValidator>
                                                </div>
                                            </div>
                                            <div class="h7">
                                            </div>
                                            <div id="divOtherInsurence" style="display: ;">
                                                <div id="divInsuranceCompany" class="mar_10by">
                                                    <div class="w650 left align_right pad_10xr">
                                                        <span class="red">*</span> Current Insurance Co.
                                                    </div>
                                                    <div class="w220 left pad_20_10x">
                                                        <asp:DropDownList ID="ddlInsuranceCompany" Width="220px" runat="server">
                                                        </asp:DropDownList>
                                                        <asp:RequiredFieldValidator ID="rfvInsuranceCompany" ControlToValidate="ddlInsuranceCompany"
                                                            CssClass="validationErrorControl" runat="server" InitialValue="-1" ValidationGroup="proposal"
                                                            Text="" ErrorMessage=""></asp:RequiredFieldValidator>
                                                    </div>
                                                    <div class="h7">
                                                    </div>
                                                </div>
                                                <div id="divInsDetails" class="mar_10by">
                                                    <div class="w650 left align_right pad_10xr">
                                                        Details
                                                    </div>
                                                    <div class="w220 left pad_20_10x">
                                                        <asp:TextBox ID="txtInsDetails" runat="server" Columns="25" MaxLength="100" Rows="2"
                                                            TextMode="MultiLine" class="text"></asp:TextBox>
                                                    </div>
                                                    <div class="h7">
                                                    </div>
                                                </div>
                                            </div>
                                            <div id="divAnyClaimsstatus" class="mar_10by">
                                                <div class="w650 left align_right pad_10xr">
                                                    <span class="red">*</span> (e) Have you ever made a claim against any insurer in
                                                    respect of any bodily injury?
                                                </div>
                                                <div class="w220 left pad_20_10x">
                                                    <span id="divYesAnyClaims">
                                                        <asp:RadioButton onclick="ShowHideDiv('divAnyClaims',true);ValAnyClaims(true);CheckAnyClaimsValidationCss();"
                                                            ID="rdoYesAnyClaims" runat="server" GroupName="anyclaims" />
                                                        <asp:Label ID="lblYesAnyClaims" class="pad_10xr" runat="server" Text="Yes"></asp:Label>
                                                    </span><span id="divNoAnyClaims">
                                                        <asp:RadioButton onclick="ShowHideDiv('divAnyClaims',false);ValAnyClaims(false);CheckAnyClaimsValidationCss();"
                                                            ID="rdoNoAnyClaims" runat="server" GroupName="anyclaims" />
                                                        <asp:Label ID="lblNoAnyClaims" runat="server" Text="No"></asp:Label>
                                                    </span>
                                                    <div style="display: none">
                                                        <asp:TextBox ID="txtAnyClaims" runat="server"></asp:TextBox>
                                                    </div>
                                                    <asp:RequiredFieldValidator ID="rfvAnyClaims" runat="server" CssClass="validationErrorControl"
                                                        Display="Dynamic" ErrorMessage="" ControlToValidate="txtAnyClaims" ValidationGroup="proposal"
                                                        Text=""></asp:RequiredFieldValidator>
                                                </div>
                                            </div>
                                            <div class="h7">
                                            </div>
                                            <div id="divAnyClaims" style="display: ;" class="mar_10by">
                                                <div class="w650 left align_right pad_10xr">
                                                    <span class="red">*</span> Please Specify
                                                </div>
                                                <div class="w220 left pad_20_10x">
                                                    <asp:TextBox ID="txtAnyClaimsReason" runat="server" Columns="25" MaxLength="100"
                                                        Rows="2" TextMode="MultiLine"></asp:TextBox>
                                                    <asp:RequiredFieldValidator ID="rfvAnyClaimsReason" ControlToValidate="txtAnyClaimsReason"
                                                        ErrorMessage="" ValidationGroup="proposal" CssClass="validationErrorControl"
                                                        runat="server"></asp:RequiredFieldValidator>
                                                </div>
                                                <div class="h7">
                                                </div>
                                            </div>
                                            <div id="divInsuranceCancelledstatus" class="mar_10by">
                                                <div class="w650 left align_right pad_10xr">
                                                    <span class="red">*</span> (f) Has your application for life or accident insurance
                                                    been declined or has any such insurance been cancelled or renewal refused or subject
                                                    to special terms?
                                                </div>
                                                <div class="w220 left pad_20_10x">
                                                    <span id="divYesInsuranceCancelled">
                                                        <asp:RadioButton onclick="ShowHideDiv('divInsuranceCancelled',true);ValInsuranceCancelled(true);CheckInsuranceCancelledValidationCss();ShowHideDiv('divPaymentMode',true);"
                                                            ID="rdoYesInsuranceCancelled" runat="server" GroupName="insurancecancelled" />
                                                        <asp:Label ID="lblYesInsuranceCancelled" class="pad_10xr" runat="server" Text="Yes"></asp:Label>
                                                    </span><span id="divNoInsuranceCancelled">
                                                        <asp:RadioButton onclick="ShowHideDiv('divInsuranceCancelled',false);ValInsuranceCancelled(false);CheckInsuranceCancelledValidationCss();ShowHideDiv('divPaymentMode',true);"
                                                            ID="rdoNoInsuranceCancelled" runat="server" GroupName="insurancecancelled" />
                                                        <asp:Label ID="lblNoInsuranceCancelled" runat="server" Text="No"></asp:Label>
                                                    </span>
                                                    <div style="display: none">
                                                        <asp:TextBox ID="txtInsuranceCancelled" runat="server"></asp:TextBox>
                                                    </div>
                                                    <asp:RequiredFieldValidator ID="rfvInsuranceCancelled" runat="server" CssClass="validationErrorControl"
                                                        Display="Dynamic" ErrorMessage="" ControlToValidate="txtInsuranceCancelled" ValidationGroup="proposal"
                                                        Text=""></asp:RequiredFieldValidator>
                                                </div>
                                            </div>
                                            <div id="divInsuranceCancelled" style="display: ;" class="mar_10by">
                                                <div class="h7">
                                                </div>
                                                <div class="w650 left align_right pad_10xr">
                                                    <span class="red">*</span> Please Specify
                                                </div>
                                                <div class="w220 left pad_20_10x">
                                                    <asp:TextBox ID="txtInsuranceCancelledReason" runat="server" Columns="25" MaxLength="100"
                                                        Rows="2" TextMode="MultiLine"></asp:TextBox>
                                                    <asp:RequiredFieldValidator ID="rfvInsuranceCancelledReason" ControlToValidate="txtInsuranceCancelledReason"
                                                        ErrorMessage="" ValidationGroup="proposal" CssClass="validationErrorControl"
                                                        runat="server"></asp:RequiredFieldValidator>
                                                </div>
                                            </div>
                                        </div>
                                        <div class="clear">
                                        </div>
                                    </div>
                                    <div class="bottom">
                                    </div>
                                </div>
                                <div class="seperator">
                                </div>

                                <script type="text/javascript">
                                    IncreaseProgress(65);
                                </script>

                                <div class="hilite" style="display: " id="divPaymentMode">
                                    <div class="top">
                                    </div>
                                    <div class="body_in pad_15x" id="divPaymentModeHeader">
                                        <h1>
                                            Payment Mode</h1>
                                        <div class="seperator">
                                        </div>
                                        I / We authorised <b>Liberty Insurance Pte. Limited</b> to debit the premium amount
                                        due in connection with above insurance policy.
                                        <div class="seperator">
                                        </div>
                                        <div>
                                            <div id="divNameoftheCard">
                                                <div class="w220 left align_right pad_6t pad_7xr">
                                                    <span class="red">*</span> Cardholder's Name:</div>
                                                <div class="left">
                                                    <asp:TextBox ID="txtNameoftheCard" MaxLength="50" runat="server" size="25"></asp:TextBox>
                                                    <asp:RequiredFieldValidator ID="rfvNameoftheCard" ControlToValidate="txtNameoftheCard"
                                                        ErrorMessage="" ValidationGroup="proposal" CssClass="validationErrorControl"
                                                        runat="server"></asp:RequiredFieldValidator>
                                                </div>
                                            </div>
                                            <div class="h10">
                                            </div>
                                            <div id="divIssuingBank">
                                                <div class="w220 left align_right pad_6t pad_7xr">
                                                    <span class="red">*</span> Issuing Bank:</div>
                                                <div class="left">
                                                    <asp:TextBox ID="txtIssuingBank" MaxLength="50" runat="server" size="25"></asp:TextBox>
                                                    <asp:RequiredFieldValidator ID="rfvIssuingBank" ControlToValidate="txtIssuingBank"
                                                        ErrorMessage="" ValidationGroup="proposal" CssClass="validationErrorControl"
                                                        runat="server"></asp:RequiredFieldValidator>
                                                </div>
                                            </div>
                                            <div class="h10">
                                            </div>
                                            <div id="divCardNo">
                                                <div class="w220 left align_right pad_6t pad_7xr">
                                                    <span class="red">*</span> Credit Card Number:</div>
                                                <div class="left">
                                                    <asp:TextBox ID="txtCardNo1" runat="server" MaxLength="4" size="8"></asp:TextBox>
                                                    <asp:TextBox ID="txtCardNo2" runat="server" MaxLength="4" size="8"></asp:TextBox>
                                                    <asp:TextBox ID="txtCardNo3" runat="server" MaxLength="4" size="8"></asp:TextBox>
                                                    <asp:TextBox ID="txtCardNo4" runat="server" MaxLength="4" size="8"></asp:TextBox>
                                                    <asp:RequiredFieldValidator ID="rfvCardNo1" ControlToValidate="txtCardNo1" ErrorMessage=""
                                                        ValidationGroup="proposal" CssClass="validationErrorControl" runat="server"></asp:RequiredFieldValidator>
                                                    <asp:RegularExpressionValidator ID="revCardNo1" runat="server" CssClass="validationErrorControl"
                                                        ErrorMessage="" ValidationGroup="proposal" ValidationExpression="[0-9]{4}" ControlToValidate="txtCardNo1"></asp:RegularExpressionValidator>
                                                    <asp:RequiredFieldValidator ID="rfvCardNo2" ControlToValidate="txtCardNo2" ErrorMessage=""
                                                        ValidationGroup="proposal" CssClass="validationErrorControl" runat="server"></asp:RequiredFieldValidator>
                                                    <asp:RegularExpressionValidator ID="revCardNo2" runat="server" CssClass="validationErrorControl"
                                                        ErrorMessage="" ValidationGroup="proposal" ValidationExpression="[0-9]{4}" ControlToValidate="txtCardNo2"></asp:RegularExpressionValidator>
                                                    <asp:RequiredFieldValidator ID="rfvCardNo3" ControlToValidate="txtCardNo3" ErrorMessage=""
                                                        ValidationGroup="proposal" CssClass="validationErrorControl" runat="server"></asp:RequiredFieldValidator>
                                                    <asp:RegularExpressionValidator ID="revCardNo3" runat="server" CssClass="validationErrorControl"
                                                        ErrorMessage="" ValidationGroup="proposal" ValidationExpression="[0-9]{4}" ControlToValidate="txtCardNo3"></asp:RegularExpressionValidator>
                                                    <asp:RequiredFieldValidator ID="rfvCardNo4" ControlToValidate="txtCardNo4" ErrorMessage=""
                                                        ValidationGroup="proposal" CssClass="validationErrorControl" runat="server"></asp:RequiredFieldValidator>
                                                    <asp:RegularExpressionValidator ID="revCardNo4" runat="server" CssClass="validationErrorControl"
                                                        ErrorMessage="" ValidationGroup="proposal" ValidationExpression="[0-9]{4}" ControlToValidate="txtCardNo4"></asp:RegularExpressionValidator>
                                                    <asp:CustomValidator CssClass="validationErrorControl" ControlToValidate="txtCreditCardValid"
                                                        ValidationGroup="proposal" ID="csvCreditCardValid" runat="server" ErrorMessage="Credit Card number not valid."
                                                        Text="" OnServerValidate="csvCreditCardValid_ServerValidate"></asp:CustomValidator>
                                                    <span style="display: none">
                                                        <asp:TextBox ID="txtCreditCardValid" Text="Valid" runat="server"></asp:TextBox>
                                                    </span>
                                                </div>
                                            </div>
                                            <div class="h10">
                                            </div>
                                            <div id="divCardExpiry">
                                                <div class="w220 left align_right pad_6t pad_7xr">
                                                    <span class="red">*</span> Card Expiry Date:</div>
                                                <div class="left">
                                                    <asp:DropDownList ID="ddlCardExpiryMonth" runat="server">
                                                        <asp:ListItem Selected="True" Value="-1">mm</asp:ListItem>
                                                        <asp:ListItem Value="01">01</asp:ListItem>
                                                        <asp:ListItem Value="02">02</asp:ListItem>
                                                        <asp:ListItem Value="03">03</asp:ListItem>
                                                        <asp:ListItem Value="04">04</asp:ListItem>
                                                        <asp:ListItem Value="05">05</asp:ListItem>
                                                        <asp:ListItem Value="06">06</asp:ListItem>
                                                        <asp:ListItem Value="07">07</asp:ListItem>
                                                        <asp:ListItem Value="08">08</asp:ListItem>
                                                        <asp:ListItem Value="09">09</asp:ListItem>
                                                        <asp:ListItem Value="10">10</asp:ListItem>
                                                        <asp:ListItem Value="11">11</asp:ListItem>
                                                        <asp:ListItem Value="12">12</asp:ListItem>
                                                    </asp:DropDownList>
                                                    <asp:DropDownList ID="ddlCardExpiryYear" runat="server">
                                                    </asp:DropDownList>
                                                    <asp:RequiredFieldValidator ID="rfvCardExpiryMonth" ControlToValidate="ddlCardExpiryMonth"
                                                        ErrorMessage="" ValidationGroup="proposal" InitialValue="-1" Text="" CssClass="validationErrorControl"
                                                        runat="server"></asp:RequiredFieldValidator>
                                                    <asp:RequiredFieldValidator ID="rfvCardExpiryYear" ControlToValidate="ddlCardExpiryYear"
                                                        ErrorMessage="" ValidationGroup="proposal" InitialValue="-1" Text="" CssClass="validationErrorControl"
                                                        runat="server"></asp:RequiredFieldValidator>
                                                    <asp:CustomValidator CssClass="validationErrorControl" ControlToValidate="txtCCExpiredValid"
                                                        ValidationGroup="proposal" ID="csvCCExpiredValid" runat="server" ErrorMessage="Credit Card expire not valid."
                                                        Text="" OnServerValidate="csvCCExpiredValid_ServerValidate"></asp:CustomValidator>
                                                    <span style="display: none">
                                                        <asp:TextBox ID="txtCCExpiredValid" Text="Valid" runat="server"></asp:TextBox>
                                                    </span>
                                                </div>
                                            </div>
                                            <div class="h10">
                                            </div>
                                            <div id="divCardType">
                                                <div class="w220 left align_right pad_6t pad_7xr">
                                                    <span class="red">*</span> Card Type:</div>
                                                <div class="left">
                                                    <span id="divVisa">
                                                        <asp:RadioButton onclick="ValCheckCardType();CheckCardTypeValidationCss();" ID="rdoVisa"
                                                            runat="server" GroupName="cardtype" />&nbsp;
                                                        <asp:Label ID="lblVisa" class="pad_10xr" runat="server" Text="VISA"></asp:Label>
                                                    </span><span id="divMasterCard">
                                                        <asp:RadioButton onclick="ValCheckCardType();CheckCardTypeValidationCss();" ID="rdoMasterCard"
                                                            runat="server" GroupName="cardtype" />&nbsp;
                                                        <asp:Label ID="lblMasterCard" runat="server" Text="MasterCard"></asp:Label>
                                                    </span>
                                                    <div style="display: none">
                                                        <asp:TextBox ID="txtCardType" runat="server"></asp:TextBox></div>
                                                    <asp:RequiredFieldValidator ID="rfvCardType" runat="server" CssClass="validationErrorControl"
                                                        Display="Dynamic" ErrorMessage="" ControlToValidate="txtCardType" ValidationGroup="proposal"
                                                        Text=""></asp:RequiredFieldValidator>
                                                    <div class="clear">
                                                    </div>
                                                    <em class="note">(Only VISA or Master Credit Card is acceptable for premium payment)</em>
                                                </div>
                                            </div>
                                        </div>
                                        <div class="seperator">
                                        </div>
                                        By submitting this proposal form, I am aware that any refund will be paid by cheque
                                        the Insured/Policyholder. <b>Liberty Insurance Pte. Limited</b> will consider all
                                        declared information as true and correct. This Credit Card payment is subject to
                                        the terms of the Credit Card Agreement.
                                    </div>
                                    <div class="bottom">
                                    </div>
                                </div>
                                <div class="seperator">
                                </div>
                                <div class="norm" id="divDeclaration">
                                    <div class="top">
                                    </div>
                                    <div class="body">
                                        <div class="pad_15x">
                                            <h1>
                                                Declaration</h1>
                                            <div class="seperator">
                                            </div>
                                            <p>
                                                I do hereby declare and warrant the answers given above in every respect are true
                                                and correct and I have not withheld any information likely to affect acceptance
                                                of this Proposal, and agree that this Proposal Declaration shall be the basis of
                                                the contract between the Company and myself, and I further agree to accept the Company's
                                                Policy subject to the terms, exclutions and conditions to be expressed therein,
                                                endorsed thereon or affected thereto.
                                            </p>
                                        </div>
                                    </div>
                                    <div class="bottom">
                                    </div>
                                </div>
                                <div class="seperator">
                                </div>
                                <div class="center align_center" id="divFormButtons">
                                    <asp:ImageButton ID="ibtSubmit" OnClientClick="LoadValidationErrorCss();CheckOptionValidationCss();"
                                        runat="server" ValidationGroup="proposal" ImageUrl="~/images/forms_proposal/button/submit.png"
                                        class="button" AlternateText="Submit Query" OnClick="ibtSubmit_Click" />
                                    <asp:Label ID="lblMessage" runat="server" ForeColor="Red"></asp:Label>
                                    <div class="note">
                                        <img src="/images/forms_proposal/icon/warning.png" width="21" height="18" alt="Note"
                                            style="vertical-align: middle; padding-bottom: 3px" />
                                        <strong>Note</strong>, by clicking on the SUBMIT button you agree to our Website's
                                        <a href="../../terms/terms.aspx" target="_blank">Terms &amp; Conditions</a>
                                    </div>
                                </div>
                            </div>
                        </div>
                        <div class="bottom">
                        </div>
                    </div>
                </div>
                <div class="seperator">
                </div>
            </div>
        </div>
    </div>
    <div id="footer">
        <div id="nav_bottom" class="pad_7t">
            <div class="left pad_8yr">
                <a href="/personal-accident/results.aspx" onclick="return confirm('Are you sure to go back?');">
                    <img src="/images/forms_proposal/button/back.png" alt="Back" /></a>
            </div>
            <div class="right pad_8yr">
                <a href="#" onclick="window.print()">
                    <img src="/images/forms_proposal/button/print.png" alt="Print" /></a>
            </div>
        </div>
    </div>

    <script type="text/javascript">
        IncreaseProgress(85);
    </script>

    <script type="text/javascript">

        function ShowHideDiv(divName, varOnOff) {
            if (varOnOff) {
                document.getElementById(divName).style.display = "";
            }
            else {
                document.getElementById(divName).style.display = "none";
            }
        }


        function CheckOptionValidationCss() {
            CheckOccupationfallValidationCss();
            CheckEngagedSportsValidationCss();
            CheckPhysicaldefectValidationCss();
            CheckOtherInsurenceValidationCss();
            CheckAnyClaimsValidationCss();
            CheckInsuranceCancelledValidationCss();
            CheckCardTypeValidationCss();
        }

        function CheckValidationCss(divYes, divNo, ctrlText, valCtrl) {
            ShowValidationEffectOption(divYes, divNo, ctrlText, valCtrl);
            return true;
        }

        function CheckValidationCssThree(div1, div2, div3, ctrlText, valCtrl) {
            ShowValidationEffectOptionThree(div1, div2, div3, ctrlText, valCtrl);
            return true;
        }

        function CheckOccupationfallValidationCss() {
            CheckValidationCss('divYesOccupationfall', 'divNoOccupationfall', '<%=txtOccupationfall.ClientID%>', '<%=rfvOccupationfall.ClientID%>');
        }

        function ValOccupationfall(varOnOff) {
            var txtCtrl = document.getElementById("<%=txtOccupationfall.ClientID%>");
            txtCtrl.value = "1";

            ValidatorEnable(document.getElementById('<%=rfvOccupationfallReason.ClientID%>'), varOnOff);
        }

        function CheckEngagedSportsValidationCss() {
            CheckValidationCss('divYesEngagedSports', 'divNoEngagedSports', '<%=txtEngagedSports.ClientID%>', '<%=rfvEngagedSports.ClientID%>');
        }

        function ValEngagedSports(varOnOff) {
            var txtCtrl = document.getElementById("<%=txtEngagedSports.ClientID%>");
            txtCtrl.value = "1";

            ValidatorEnable(document.getElementById('<%=rfvEngagedSportsReason.ClientID%>'), varOnOff);
        }

        function CheckPhysicaldefectValidationCss() {
            CheckValidationCss('divYesPhysicaldefect', 'divNoPhysicaldefect', '<%=txtPhysicaldefect.ClientID%>', '<%=rfvPhysicaldefect.ClientID%>');
        }

        function ValPhysicaldefect(varOnOff) {
            var txtCtrl = document.getElementById("<%=txtPhysicaldefect.ClientID%>");
            txtCtrl.value = "1";

            ValidatorEnable(document.getElementById('<%=rfvPhysicaldefectReason.ClientID%>'), varOnOff);
        }

        function CheckOtherInsurenceValidationCss() {
            CheckValidationCss('divYesOtherInsurence', 'divNoOtherInsurence', '<%=txtOI.ClientID%>', '<%=rfvOI.ClientID%>');
        }

        function ValOtherInsurence(varOnOff) {
            var txtCtrl = document.getElementById("<%=txtOI.ClientID%>");
            txtCtrl.value = "1";

            ValidatorEnable(document.getElementById('<%=rfvInsuranceCompany.ClientID%>'), varOnOff);
        }

        function CheckAnyClaimsValidationCss() {
            CheckValidationCss('divYesAnyClaims', 'divNoAnyClaims', '<%=txtAnyClaims.ClientID%>', '<%=rfvAnyClaims.ClientID%>');
        }

        function ValAnyClaims(varOnOff) {
            var txtCtrl = document.getElementById("<%=txtAnyClaims.ClientID%>");
            txtCtrl.value = "1";

            ValidatorEnable(document.getElementById('<%=rfvAnyClaimsReason.ClientID%>'), varOnOff);
        }

        function CheckInsuranceCancelledValidationCss() {
            CheckValidationCss('divYesInsuranceCancelled', 'divNoInsuranceCancelled', '<%=txtInsuranceCancelled.ClientID%>', '<%=rfvInsuranceCancelled.ClientID%>');
        }

        function ValInsuranceCancelled(varOnOff) {
            var txtCtrl = document.getElementById("<%=txtInsuranceCancelled.ClientID%>");
            txtCtrl.value = "1";

            ValidatorEnable(document.getElementById('<%=rfvInsuranceCancelledReason.ClientID%>'), varOnOff);
        }

        function CheckCardTypeValidationCss() {
            CheckValidationCss('divVisa', 'divMasterCard', '<%=txtCardType.ClientID%>', '<%=rfvCardType.ClientID%>');
        }

        function ValCheckCardType(varOnOff) {
            var txtCtrl = document.getElementById("<%=txtCardType.ClientID%>");
            txtCtrl.value = "1";
        }


//        function CheckSalGenderValid(source, arguments) {
//            var ctrlsal = document.getElementById('<=ddlSalutation.ClientID>' + '_ddlSal');
//            var ctrlgender = document.getElementById('<=ddlGender.ClientID>' + '_ddlGender');

//            var sal = ctrlsal.value;
//            var gender = ctrlgender.value;
//            var result = true;
//            if (gender == 'M') {
//                if (sal == 'Ms' || sal == 'Miss' || sal == 'Mdm' || sal == 'Mrs') {
//                    result = false;
//                }
//            }
//            else if (gender == 'F') {
//                if (sal == 'Mr') {
//                    result = false;
//                }
//            }

//            if (result == false) {
//                ctrlsal.style.backgroundColor = '#fcc';
//                ctrlsal.style.border = 'Solid 1px #f00';

//                ctrlgender.style.backgroundColor = '#fcc';
//                ctrlgender.style.border = 'Solid 1px #f00';
//            }
//            else {
//                ctrlsal.style.backgroundColor = '';
//                ctrlsal.style.border = '';

//                ctrlgender.style.backgroundColor = '';
//                ctrlgender.style.border = '';
//            }
//            arguments.IsValid = result;
//        }

//        var hookAVal = false;
//        function HookSalValidation() {
//            if (hookAVal == false) {
//                prefix = "<=ddlSalutation.ClientID>";
//                var ddlSal = prefix + "_ddlSal";
//                prefix = "<=ddlGender.ClientID>";
//                var ddlGender = prefix + "_ddlGender";
//                var valCtrl = "<=csvSalGender.ClientID>";
//                ValidatorHookupControlID(ddlSal, document.getElementById(valCtrl));
//                ValidatorHookupControlID(ddlGender, document.getElementById(valCtrl));
//                hookAVal = true;
//            }
//        }

        function Check2NRICValid(source, arguments) {
            var ddlnricpref = document.getElementById('<%=ddlIdNumber.ClientID%>' + '_ddlIdPrefix');
            var txtnricnum = document.getElementById('<%=ddlIdNumber.ClientID%>' + '_txtIdNumber');
            var ddlnricsuffix = document.getElementById('<%=ddlIdNumber.ClientID%>' + '_ddlIdPostfix');
            var applicantNRIC = ddlnricpref.value + txtnricnum.value + ddlnricsuffix.value;

            var ddlspousenricpref = document.getElementById('<%=ddlSpouseIdNumber.ClientID%>' + '_ddlIdPrefix');
            var txtspousenricnum = document.getElementById('<%=ddlSpouseIdNumber.ClientID%>' + '_txtIdNumber');
            var ddlspousenricsuffix = document.getElementById('<%=ddlSpouseIdNumber.ClientID%>' + '_ddlIdPostfix');
            var spouseNRIC = ddlspousenricpref.value + txtspousenricnum.value + ddlspousenricsuffix.value;
         
            var result = true;

            //alert(applicantNRIC + ' ' + spouseNRIC);

            if (applicantNRIC == spouseNRIC) {             
                    result = false;             
            }
            else
            {
                 result = true;    
            }

            if (result == false) {
                ddlnricpref.style.backgroundColor = '#fcc';
                ddlnricpref.style.border = 'Solid 1px #f00';
                txtnricnum.style.backgroundColor = '#fcc';
                txtnricnum.style.border = 'Solid 1px #f00';
                ddlnricsuffix.style.backgroundColor = '#fcc';
                ddlnricsuffix.style.border = 'Solid 1px #f00';

                ddlspousenricpref.style.backgroundColor = '#fcc';
                ddlspousenricpref.style.border = 'Solid 1px #f00';
                txtspousenricnum.style.backgroundColor = '#fcc';
                txtspousenricnum.style.border = 'Solid 1px #f00';
                ddlspousenricsuffix.style.backgroundColor = '#fcc';
                ddlspousenricsuffix.style.border = 'Solid 1px #f00';
            }
            else {
                ddlnricpref.style.backgroundColor = '';
                ddlnricpref.style.border = '';
                txtnricnum.style.backgroundColor = '';
                txtnricnum.style.border = '';
                ddlnricsuffix.style.backgroundColor = '';
                ddlnricsuffix.style.border = '';

                ddlspousenricpref.style.backgroundColor = '';
                ddlspousenricpref.style.border = '';
                txtspousenricnum.style.backgroundColor = '';
                txtspousenricnum.style.border = '';
                ddlspousenricsuffix.style.backgroundColor = '';
                ddlspousenricsuffix.style.border = '';
            }
            arguments.IsValid = result;
        }

        var hookCompareVal = false;
        function HookCompareICValidation() {
//            if (hookCompareVal == false) {
//                prefix = "<%=ddlIdNumber.ClientID%>";
//                var ddlnricpref = prefix + "_ddlIdPrefix";
//                var txtnricnum = prefix + "_txtIdNumber";
//                var ddlnricsuffix = prefix + "_ddlIdPostfix";
//                
//                prefix = "<%=ddlSpouseIdNumber.ClientID%>";
//                var ddlspousenricpref = prefix + "_ddlIdPrefix";
//                var txtspousenricnum = prefix + "_txtIdNumber";
//                var ddlspousenricsuffix = prefix + "_ddlIdPostfix";
//                var valCtrl = "<=csvNRIC.ClientID>";

//                ValidatorHookupControlID(ddlnricpref, document.getElementById(valCtrl));
//                ValidatorHookupControlID(txtnricnum, document.getElementById(valCtrl));
//                ValidatorHookupControlID(ddlnricsuffix, document.getElementById(valCtrl));
//                ValidatorHookupControlID(ddlspousenricpref, document.getElementById(valCtrl));
//                ValidatorHookupControlID(txtspousenricnum, document.getElementById(valCtrl));
//                ValidatorHookupControlID(ddlspousenricsuffix, document.getElementById(valCtrl));
                hookCompareVal = true;
//            }
        }

        //    function EnableDisableValidations() 
        //    {
        //        var policytype = document.getElementById('<%=txtIsCover.ClientID%>').value;
        //        if (policytype == 'IND') 
        //        {
        //            ValidationSpouse(false);
        //            ValidationChild1(false);
        //            ValidationChild2(false);
        //            ValidationChild3(false);
        //            ValidationChild4(false);
        //            ValidationChild5(false);
        //        }
        //        else if (policytype == 'INDSP') 
        //        {
        //            ValidationSpouse(true);
        //            ValidationChild1(false);
        //            ValidationChild2(false);
        //            ValidationChild3(false);
        //            ValidationChild4(false);
        //            ValidationChild5(false);
        //        }
        //        else if (policytype == 'INDCHD') 
        //        {
        //            ValidationSpouse(false);
        //            EnableDisableChildValidations(); 
        //        }
        //        else 
        //        {
        //            ValidationSpouse(true);
        //            EnableDisableChildValidations(); 
        //        }
        //    }
        //    function EnableDisableChildValidations() 
        //    {
        //        var childcount = document.getElementById('<%=txtCHCount.ClientID%>').value;
        //        if (childcount == 1) {
        //            ValidationChild1(true);
        //            ValidationChild2(false);
        //            ValidationChild3(false);
        //            ValidationChild4(false);
        //            ValidationChild5(false);
        //        }
        //        else if (childcount == 2) {
        //            ValidationChild1(true);
        //            ValidationChild2(true);
        //            ValidationChild3(false);
        //            ValidationChild4(false);
        //            ValidationChild5(false);
        //        }
        //        else if (childcount == 3) {
        //            ValidationChild1(true);
        //            ValidationChild2(true);
        //            ValidationChild3(true);
        //            ValidationChild4(false);
        //            ValidationChild5(false);
        //        }
        //        else if (childcount == 4) {
        //            ValidationChild1(true);
        //            ValidationChild2(true);
        //            ValidationChild3(true);
        //            ValidationChild4(true);
        //            ValidationChild5(false);
        //        }
        //        else if (childcount == 5) {
        //            ValidationChild1(true);
        //            ValidationChild2(true);
        //            ValidationChild3(true);
        //            ValidationChild4(true);
        //            ValidationChild5(true);
        //        }
        //    }

        //    function ValidationSpouse(varOnOff) 
        //    {
        //        ValidatorEnable(document.getElementById('<%=rfvSpouseName.ClientID%>'), varOnOff);
        //        ValidatorEnable(document.getElementById('<%=revSpouseName.ClientID%>'), varOnOff);
        //        ValidatorEnable(document.getElementById('<=ddlSpouseGender.ClientI%>' + "_rfvGender"), varOnOff);
        //        ValidatorEnable(document.getElementById('<%=ddlSpouseIdNumber.ClientID%>' + "_csvIdPrefix"), varOnOff);
        //        ValidatorEnable(document.getElementById('<%=ddlSpouseIdNumber.ClientID%>' + "_rfvIdNumber"), varOnOff);
        //        ValidatorEnable(document.getElementById('<%=ddlSpouseIdNumber.ClientID%>' + "_revIdNumberLength"), varOnOff);
        //        ValidatorEnable(document.getElementById('<%=ddlSpouseIdNumber.ClientID%>' + "_csvIdNumber"), varOnOff);
        //        ValidatorEnable(document.getElementById('<%=ddlSpouseIdNumber.ClientID%>' + "_csvIdPostfix"), varOnOff);
        //        ValidatorEnable(document.getElementById('<%=ddlNationality.ClientID%>' + "_rfvNationality"), varOnOff);
        //        ValidatorEnable(document.getElementById('<=ddlSpouseRelationship.ClientID>' + "_rfvRelationship"), varOnOff);
        //    }

        //    function ValidationChild1(varOnOff) {
        //        ValidatorEnable(document.getElementById('<%=rfvChildName1.ClientID%>'), varOnOff);
        //        ValidatorEnable(document.getElementById('<%=revChildName1.ClientID%>'), varOnOff);
        //        IsEnableDateValidation('<%=ddlChildDOB1.ClientID%>', varOnOff);
        //        ValidatorEnable(document.getElementById('<%=ddlChildGender1.ClientID%>' + "_rfvGender"), varOnOff);
        //        ValidatorEnable(document.getElementById('<%=ddlChildIdNumber1.ClientID%>' + "_csvIdPrefix"), varOnOff);
        //        ValidatorEnable(document.getElementById('<%=ddlChildIdNumber1.ClientID%>' + "_rfvIdNumber"), varOnOff);
        //        ValidatorEnable(document.getElementById('<%=ddlChildIdNumber1.ClientID%>' + "_revIdNumberLength"), varOnOff);
        //        ValidatorEnable(document.getElementById('<%=ddlChildIdNumber1.ClientID%>' + "_csvIdNumber"), varOnOff);
        //        ValidatorEnable(document.getElementById('<%=ddlChildIdNumber1.ClientID%>' + "_csvIdPostfix"), varOnOff);
        //        ValidatorEnable(document.getElementById('<%=ddlChildNationality1.ClientID%>' + "_rfvNationality"), varOnOff);
        //        ValidatorEnable(document.getElementById('<=ddlChildRelationship1.ClientID>' + "_rfvRelationship"), varOnOff);
        //    }

        //    function ValidationChild2(varOnOff) {
        //        ValidatorEnable(document.getElementById('<%=rfvChildName2.ClientID%>'), varOnOff);
        //        ValidatorEnable(document.getElementById('<%=revChildName2.ClientID%>'), varOnOff);
        //        IsEnableDateValidation('<%=ddlChildDOB2.ClientID%>', varOnOff);
        //        ValidatorEnable(document.getElementById('<%=ddlChildGender2.ClientID%>' + "_rfvGender"), varOnOff);
        //        ValidatorEnable(document.getElementById('<%=ddlChildIdNumber2.ClientID%>' + "_csvIdPrefix"), varOnOff);
        //        ValidatorEnable(document.getElementById('<%=ddlChildIdNumber2.ClientID%>' + "_rfvIdNumber"), varOnOff);
        //        ValidatorEnable(document.getElementById('<%=ddlChildIdNumber2.ClientID%>' + "_revIdNumberLength"), varOnOff);
        //        ValidatorEnable(document.getElementById('<%=ddlChildIdNumber2.ClientID%>' + "_csvIdNumber"), varOnOff);
        //        ValidatorEnable(document.getElementById('<%=ddlChildIdNumber2.ClientID%>' + "_csvIdPostfix"), varOnOff);
        //        ValidatorEnable(document.getElementById('<%=ddlChildNationality2.ClientID%>' + "_rfvNationality"), varOnOff);
        //        ValidatorEnable(document.getElementById('<=ddlChildRelationship2.ClientID>' + "_rfvRelationship"), varOnOff);
        //    }

        //    function ValidationChild3(varOnOff) {
        //        ValidatorEnable(document.getElementById('<%=rfvChildName3.ClientID%>'), varOnOff);
        //        ValidatorEnable(document.getElementById('<%=revChildName3.ClientID%>'), varOnOff);
        //        IsEnableDateValidation('<%=ddlChildDOB3.ClientID%>', varOnOff);
        //        ValidatorEnable(document.getElementById('<%=ddlChildGender3.ClientID%>' + "_rfvGender"), varOnOff);
        //        ValidatorEnable(document.getElementById('<%=ddlChildIdNumber3.ClientID%>' + "_csvIdPrefix"), varOnOff);
        //        ValidatorEnable(document.getElementById('<%=ddlChildIdNumber3.ClientID%>' + "_rfvIdNumber"), varOnOff);
        //        ValidatorEnable(document.getElementById('<%=ddlChildIdNumber3.ClientID%>' + "_revIdNumberLength"), varOnOff);
        //        ValidatorEnable(document.getElementById('<%=ddlChildIdNumber3.ClientID%>' + "_csvIdNumber"), varOnOff);
        //        ValidatorEnable(document.getElementById('<%=ddlChildIdNumber3.ClientID%>' + "_csvIdPostfix"), varOnOff);
        //        ValidatorEnable(document.getElementById('<%=ddlChildNationality3.ClientID%>' + "_rfvNationality"), varOnOff);
        //        ValidatorEnable(document.getElementById('<=ddlChildRelationship3.ClientID>' + "_rfvRelationship"), varOnOff);
        //    }

        //    function ValidationChild4(varOnOff) {
        //        ValidatorEnable(document.getElementById('<%=rfvChildName4.ClientID%>'), varOnOff);
        //        ValidatorEnable(document.getElementById('<%=revChildName4.ClientID%>'), varOnOff);
        //        IsEnableDateValidation('<%=ddlChildDOB4.ClientID%>', varOnOff);
        //        ValidatorEnable(document.getElementById('<%=ddlChildGender4.ClientID%>' + "_rfvGender"), varOnOff);
        //        ValidatorEnable(document.getElementById('<%=ddlChildIdNumber4.ClientID%>' + "_csvIdPrefix"), varOnOff);
        //        ValidatorEnable(document.getElementById('<%=ddlChildIdNumber4.ClientID%>' + "_rfvIdNumber"), varOnOff);
        //        ValidatorEnable(document.getElementById('<%=ddlChildIdNumber4.ClientID%>' + "_revIdNumberLength"), varOnOff);
        //        ValidatorEnable(document.getElementById('<%=ddlChildIdNumber4.ClientID%>' + "_csvIdNumber"), varOnOff);
        //        ValidatorEnable(document.getElementById('<%=ddlChildIdNumber4.ClientID%>' + "_csvIdPostfix"), varOnOff);
        //        ValidatorEnable(document.getElementById('<%=ddlChildNationality4.ClientID%>' + "_rfvNationality"), varOnOff);
        //        ValidatorEnable(document.getElementById('<=ddlChildRelationship4.ClientID>' + "_rfvRelationship"), varOnOff);
        //    }

        //    function ValidationChild5(varOnOff) {
        //        ValidatorEnable(document.getElementById('<%=rfvChildName5.ClientID%>'), varOnOff);
        //        ValidatorEnable(document.getElementById('<%=revChildName5.ClientID%>'), varOnOff);
        //        IsEnableDateValidation('<%=ddlChildDOB5.ClientID%>', varOnOff);
        //        ValidatorEnable(document.getElementById('<%=ddlChildGender5.ClientID%>' + "_rfvGender"), varOnOff);
        //        ValidatorEnable(document.getElementById('<%=ddlChildIdNumber5.ClientID%>' + "_csvIdPrefix"), varOnOff);
        //        ValidatorEnable(document.getElementById('<%=ddlChildIdNumber5.ClientID%>' + "_rfvIdNumber"), varOnOff);
        //        ValidatorEnable(document.getElementById('<%=ddlChildIdNumber5.ClientID%>' + "_revIdNumberLength"), varOnOff);
        //        ValidatorEnable(document.getElementById('<%=ddlChildIdNumber5.ClientID%>' + "_csvIdNumber"), varOnOff);
        //        ValidatorEnable(document.getElementById('<%=ddlChildIdNumber5.ClientID%>' + "_csvIdPostfix"), varOnOff);
        //        ValidatorEnable(document.getElementById('<%=ddlChildNationality5.ClientID%>' + "_rfvNationality"), varOnOff);
        //        ValidatorEnable(document.getElementById('<=ddlChildRelationship5.ClientID>' + "_rfvRelationship"), varOnOff);
        //    }

        function CheckAll() {
            //HookSalValidation();
            HookCompareICValidation();
        }
        function showhide(el) {

            el = document.getElementById(el);
            el.style.display = (el.style.display == "none") ? "block" : "none";

        }

        window.onload = function() {
            //showhide('divOtherOnformation');
            showhide('divOccupationfall');
            showhide('divEngagedSports');
            showhide('divPhysicaldefect');
            showhide('divOtherInsurence');
            showhide('divAnyClaims');
            showhide('divInsuranceCancelled');
            //showhide('divPaymentMode');
            //EnableDisableValidations();

            if (document.getElementById('<%=rdoYesOccupationfall.ClientID%>').checked == true) {
                ShowHideDiv('divOccupationfall', true);
                ValOccupationfall(true);
            }
            else if (document.getElementById('<%=rdoNoOccupationfall.ClientID%>').checked == true) {
                ShowHideDiv('divOccupationfall', false);
                ValOccupationfall(false);
            }
            else { ShowHideDiv('divOccupationfall', false); }

            if (document.getElementById('<%=rdoYesEngagedSports.ClientID%>').checked == true) {
                ShowHideDiv('divEngagedSports', true);
                ValEngagedSports(true);
            }
            else if (document.getElementById('<%=rdoNoEngagedSports.ClientID%>').checked == true) {
                ShowHideDiv('divEngagedSports', false);
                ValEngagedSports(false);
            }
            else { ShowHideDiv('divEngagedSports', false); }

            if (document.getElementById('<%=rdoYesPhysicaldefect.ClientID%>').checked == true) {
                ShowHideDiv('divPhysicaldefect', true);
                ValPhysicaldefect(true);
            }
            else if (document.getElementById('<%=rdoNoPhysicaldefect.ClientID%>').checked == true) {
                ShowHideDiv('divPhysicaldefect', false);
                ValPhysicaldefect(false);
            }
            else { ShowHideDiv('divPhysicaldefect', false); }

            if (document.getElementById('<%=rdoYesOtherInsurence.ClientID%>').checked == true) {
                ShowHideDiv('divOtherInsurence', true);
                ValOtherInsurence(true);
            }
            else if (document.getElementById('<%=rdoNoOtherInsurence.ClientID%>').checked == true) {
                ShowHideDiv('divOtherInsurence', false);
                ValOtherInsurence(false);
            }
            else { ShowHideDiv('divOtherInsurence', false); }

            if (document.getElementById('<%=rdoYesAnyClaims.ClientID%>').checked == true) {
                ShowHideDiv('divAnyClaims', true);
                ValAnyClaims(true);
            }
            else if (document.getElementById('<%=rdoNoAnyClaims.ClientID%>').checked == true) {
                ShowHideDiv('divAnyClaims', false);
                ValAnyClaims(false);
            }
            else { ShowHideDiv('divAnyClaims', false); }

            if (document.getElementById('<%=rdoYesInsuranceCancelled.ClientID%>').checked == true) {
                ShowHideDiv('divInsuranceCancelled', true);
                ValInsuranceCancelled(true);
            }
            else if (document.getElementById('<%=rdoNoInsuranceCancelled.ClientID%>').checked == true) {
                ShowHideDiv('divInsuranceCancelled', false);
                ValInsuranceCancelled(false);
            }
            else { ShowHideDiv('divInsuranceCancelled', false); }

            if (document.getElementById('<%=txtCardType.ClientID%>').value == "1") {
                ShowHideDiv('divPaymentMode', true);
            }
            else { ShowHideDiv('divPaymentMode', true); }
        }


        function restrictToNumbers(e) {
            if ([e.keyCode || e.which] == 8 || [e.keyCode || e.which] == 37 || [e.keyCode || e.which] == 9 || [e.keyCode || e.which] == 39) //this is to allow backspace
                return true;

            if ([e.keyCode || e.which] < 48 || [e.keyCode || e.which] > 57)
                e.preventDefault ? e.preventDefault() : e.returnValue = false;
        }

        function requestByPostCode() {
            try {
                var _pcode = document.getElementById('<%=txtPostCode.ClientID%>').value;
                if (_pcode.length != 6) {
                    alert('Postal code length must be 6 numbers value.');
                    document.getElementById('<%=txtAddress.ClientID%>').value = '';
                    return false;
                }
                else {
                    requestData(_pcode);
                }
            }
            catch (e) {
                alert(e.toString());
            }
        }


        function set_data(json) {
            try {
                var srcTable = $("#divAddress").empty();
                var txtAddress = document.getElementById('<%=txtAddress.ClientID%>');
                if (json == null) {
                    $("<table><tr><td>No address found!</td></tr></table>").appendTo(srcTable);
                    alert("No address found!");
                    document.getElementById('<%=txtPostCode.ClientID%>').value = "";
                    txtAddress.value = "No Address found.";
                    return;
                }
                if (json.length == 0) {
                    $("<table><tr><td>No address found!</td></tr></table>").appendTo(srcTable);
                    alert("No address found!");
                    document.getElementById('<%=txtPostCode.ClientID%>').value = "";
                    txtAddress.value = "No Address found.";
                    return;
                }

                var tbl = $("<table width='50%'>");

                var tbody = $("<tbody>");
                var no = 1;
                for (var i = 0; i < json.length; i++) {
                    var trow = $("<tr>"), rec = json[i];
                    if (rec.t != null) {

                        var ctn = rec.t + "<br>" + rec.a;

                        //$("<td>").text(no).data("col", 1).appendTo(trow);
                        $("<td>").html(ctn).data("col", 2).appendTo(trow);
                        if (i == 0) {
                            txtAddress.value = rec.t + "\n" + rec.a;
                        }
                        else {
                            txtAddress.value += "\n\n" + rec.t + "\n" + rec.a;
                        }
                        no++;
                    }
                    trow.appendTo(tbody);
                }
                tbody.appendTo(tbl);
                //alert(srcTable);
                tbl.appendTo(srcTable);
            }
            catch (e) {
                alert(e.toString());
            }
        }

        function PostCodeChange() {
            document.getElementById('divAddress').innerHTML = "Your postcode changed.";
            document.getElementById('divAddress').style.display = 'none';
            document.getElementById('<%=txtAddress.ClientID%>').innerHTML = "Your postcode changed.\nGetting address from street directory...";
        }
    </script>

    <script type="text/javascript">
        IncreaseProgress(100);
        HideLoading();
    </script>
    <script src="../../includes/personalaccident/liberty.proposalform.js" type="text/javascript"></script>

</asp:Content>
